WHO: Marburg virus disease (MVD)
  • ๐Ÿ”‘ Key points
  • ๐ŸŒ Geospatial distribution
  • ๐Ÿฆ  Marburg disease transmission
  • ๐Ÿ‘จ๐Ÿฝโ€โš•๏ธ Symptoms of Marburg virus disease
  • ๐Ÿ”ฌ Diagnosis
  • ๐Ÿ’Š ๐Ÿ’‰ Treatment and Prevention
  • ๐Ÿฆ‡ Marburg virus in animals
  • ๐ŸงคPrevention and control
  • ๐Ÿฅ Controlling infection in healthcare settings

To be updated with VHF team specific language and hyperlinks. For more information, visit the WHO website.

Total countries

19

Total outbreaks

27

Latest events

2024

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Overview
  • Marburg virus (MARV) and Ravn virus (RAVV) of the species Orthomarburgvirus marburgense are the causative agents of Marburg virus disease (MVD). The disease has a case fatality ratio of up to 88%, but it can be much lower with good and early patient care.

  • Both viruses are part of the Filoviridae family (filovirus) to which Orthoebolavirus genus belongs. Though caused by different viruses, Ebola and Marburg diseases are clinically similar. Both diseases are rare but have the capacity to cause outbreaks with high fatality rates.

  • MVD was initially detected in 1967 after two simultaneous outbreaks in Marburg and Frankfurt in Germany, and in Belgrade, Serbia. These outbreaks were associated with laboratory work using African green monkeys (Cercopithecus aethiops) imported from Uganda. Subsequently, outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Equatorial Guinea, Ghana, Guinea, Kenya, South Africa (in a person with recent travel history to Zimbabwe), Tanzania and Uganda. In 2008, two independent cases were reported in travellers who had visited a cave inhabited by Rousettus aegyptiacus bat colonies in Uganda.

Key Facts
  • Marburg virus disease (MVD), formerly known as Marburg haemorrhagic fever, is a severe, often fatal illness in humans.
  • The average MVD case fatality rate is around 50%. Case fatality rates have varied from 24% to 88% in past outbreaks.
  • Early supportive care with rehydration, and symptomatic treatment improves survival.
  • There are currently no approved vaccines or antiviral treatments for MVD, but a range of vaccines and drug therapies are under development.
  • Rousettus aegyptiacus, a fruit bat of the Pteropodidae family, is considered the natural host of Marburg virus. The virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission.
  • Community engagement is key to successfully controlling outbreaks.
At a glance
Worldwide geospatial distribution
  • Africa
  • Europe
Worldwide cases
Country Cases Deaths CFR
AFR
United Republic of Tanzania 10 7 1%
Equatorial Guinea 41 36 1%
Ghana 4 3 1%
Guinea 2 2 1%
Uganda 24 11 0%
Angola 375 330 1%
Democratic Republic of the Congo 155 129 1%
Kenya 4 3 1%
South Africa 4 2 0%
EUR
Netherlands (Kingdom of the) 2 2 1%
Serbia, Croatia and Slovenia 3 1 0%
Germany 30 8 0%
AMR
United States of America 2 1 0%

Source: WHO.

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts
  • Initially, human MVD infection results from prolonged exposure to mines or caves inhabited by Rousettus fruit bat colonies.
  • Once introduced in the human population, Marburg virus can spread through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.
  • Healthcare workers have frequently been infected while treating patients with suspected or confirmed MVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Transmission via contaminated injection equipment or through needle-stick injuries is associated with more severe disease, rapid deterioration, and possibly a higher fatality rate.
  • Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg virus.
  • People cannot transmit the disease before they have symptoms and remain infectious as long as their blood contains the virus.
Note
Transmission sequence

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts
  • The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days.

  • MVD begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Non-itchy rash have been reported in patients between 2 and 7 days after onset of symptoms.

  • From day 5 of the disease, patients may develop haemorrhagic manifestations, including fresh blood in vomitus and faeces, and bleeding from the nose, gums and vagina. Bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can also be observed. Involvement of the central nervous system can result in confusion, irritability and aggression. Orchitis (inflammation of one or both testicles) has been reported occasionally in the late phase of disease.

  • In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.

Note
Symptoms

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts

It can be difficult to clinically distinguish MVD from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers. Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods:

  • antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • antigen-capture detection tests
  • reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • virus isolation by cell culture in maximum containment laboratories.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All non-inactivated biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

Stepwise approach
Diagnosis approaches

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts
  • Early intensive supportive care including rehydration and treatment of specific symptoms, can improve survival.

  • Currently there are no vaccines or antiviral treatments approved for MVD.โ€“

  • There are candidate monoclonal antibodies (mAbs) and antivirals, along with candidate vaccines that can be evaluated in [clinical trials](https://www.who.int/teams/blueprint/ebolavirus.

At a glance
Treatment approaches

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts
  • Rousettus aegyptiacus bats are considered natural hosts for Marburg virus. There is no apparent disease in these fruit bats. As a result, the geographic distribution of Marburg virus may overlap with the range of Rousettus bats.

  • African green monkeys (Cercopithecus aethiops) imported from Uganda were the source of infection for humans during the first MVD outbreak.

  • Experimental inoculations in pigs with different Orthoebolavirus species indicated that pigs are susceptible to filovirus infection and shed the virus. Therefore, pigs should be considered as a potential amplifier host during MVD outbreaks. Precautionary measures are needed in pig farms in Africa to avoid pigs becoming infected through contact with fruit bats.

At a glance

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts

Community engagement is key to successfully controlling any outbreaks. Outbreak control relies on using a range of interventions, such as case management, surveillance and contact tracing, good laboratory service, infection prevention and control in health facilities, safe and dignified burials and social mobilization.

Raising awareness of risk factors for MVD and protective measures that individuals can take is an effective way to reduce human transmission.

Risk reduction messaging should focus on several factors:

  • Reducing the risk of bat-to-human transmission arising from prolonged exposure to mines or caves inhabited by fruit bat colonies. People with visiting or working in in mines or caves inhabited by fruit bat colonies, people should wear gloves and other appropriate protective clothing (including masks). During outbreaks all animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their body fluids. Close physical contact with MVD patients should be avoided. Patients suspected or confirmed for MVD should be isolated in a designated treatment centre for early care and to avoid transmission at home.
  • Communities affected by MVD should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures.
  • Outbreak containment measures include safe and dignified burial of the deceased, identifying people who may have been in contact with someone infected with MVD and monitoring their health for 21 days, separating the healthy from the sick to prevent further spread and providing care to confirmed patient and maintaining good hygiene and a clean environment need to be observed.
At a glance

Total cases

662

Total deaths

537

Mean CFR (%)

63%

Key Facts
  • Healthcare workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe and dignified burial practices.

  • Healthcare workers caring for patients with suspected or confirmed MVD should apply extra infection control measures to prevent contact with the patientโ€™s blood and body fluids and contaminated surfaces or materials such as clothing and bedding.

  • Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Marburg virus infection should be handled by trained staff and processed in suitably equipped laboratories.

Measures


This dashboard displays MVD data for:

Total countries: 19
Total events: 27
Most recent: 2024
As of: 2024-11-27


Disclaimer

To be updated with VHF team specific language and hyperlinks. For more information, visit the WHO website.